Kimura I, Ayyar D R, Lippmann S M
Tohoku J Exp Med. 1984 Feb;142(2):165-72. doi: 10.1620/tjem.142.165.
Reliable, technically not demanding, electrophysiological tests make it possible to diagnose the ulnar entrapment neuropathy at the elbow. Ulnar nerve was stimulated supramaximally at the wrist, below and above the elbow, and in the upper arm, and the sensory nerve action potential (SNAP) and compound muscle action potential (CMAP) were recorded. Sensory and motor nerve conduction velocities (SNCVs, MNCVs) were calculated in each segment. In 12 of 64 symptomatic extremities of 44 patients with a presumptive diagnosis of the ulnar neuropathy at the elbow MNCVs of all segments were within normal limit and only SNCV across the elbow was significantly slowed (p less than 0.001). In 25 extremities of the patients SNAP was not obtained. Evidence of denervation in the first dorsal interosseous and abductor digiti minimi muscles was detected in about 50% hands tested. This percentage was higher in the hands with absence of SNAP than those with presence of SNAPs. It would appear that measurement of SNCV across the elbow is a more sensitive parameter to detect abnormal conduction across the cubital tunnel in patients with the ulnar neuropathy.
可靠且技术要求不高的电生理检查能够诊断肘部尺神经卡压性神经病。在腕部、肘部下方和上方以及上臂对尺神经进行超强刺激，并记录感觉神经动作电位（SNAP）和复合肌肉动作电位（CMAP）。计算每个节段的感觉和运动神经传导速度（SNCV、MNCV）。在44例初步诊断为肘部尺神经病变的患者的64个有症状肢体中，有12个肢体所有节段的MNCV均在正常范围内，仅肘部的SNCV明显减慢（p小于0.001）。25个患者肢体未获得SNAP。在约50%接受检查的手部中检测到第一背侧骨间肌和小指展肌失神经支配的证据。无SNAP的手部中该百分比高于有SNAP的手部。似乎测量肘部的SNCV是检测尺神经病变患者肘管异常传导的更敏感参数。
